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Trauma disparities

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https://www.readbyqxmd.com/read/29221878/universal-insurance-and-an-equal-access-healthcare-system-eliminate-disparities-for-black-patients-after-traumatic-injury
#1
Muhammad Ali Chaudhary, Meesha Sharma, Rebecca E Scully, Daniel J Sturgeon, Tracey Koehlmoos, Adil H Haider, Andrew J Schoenfeld
BACKGROUND: Although inequities in trauma care are reported widely, some groups have theorized that universal health insurance would decrease disparities in care for disadvantaged minorities after a traumatic injury. We sought to examine the presence of racial disparities in outcomes and healthcare utilization at 30- and 90-days after discharge in this universally insured, racially diverse, American population treated for traumatic injuries. METHODS: This work studied adult beneficiaries of TRICARE treated at both military and civilian trauma centers 2006-2014...
December 5, 2017: Surgery
https://www.readbyqxmd.com/read/29211633/prevalence-and-patterns-of-victimization-and-polyvictimization-among-female-sex-workers-in-soweto-a-south-african-township-a-cross-sectional-respondent-driven-sampling-study
#2
J Coetzee, G E Gray, R Jewkes
BACKGROUND: Female sex workers (FSWs) are disproportionately affected by violence from multiple partner categories. This increases their vulnerability to HIV. OBJECTIVES: To describe patterns of violence and polyvictimization among female SWs in Soweto. METHODS: A respondent-driven sampling (RDS) recruitment methodology was used to enrol 508 Soweto-based FSWs using a survey instrument. Raw and RDS adjusted data were descriptively analysed, Spearman's correlation and chi2 test of association were used to show associations...
2017: Global Health Action
https://www.readbyqxmd.com/read/29180184/status-of-trauma-quality-improvement-programs-in-the-americas-a-survey-of-trauma-care-providers
#3
Hilary L Zetlen, Lacey N LaGrone, Jorge Esteban Foianini, Eduardo Huaman Egoavil, Jorge Sproviero, Felipe Vega Rivera, Charles N Mock
INTRODUCTION: Global disparities in trauma care contribute to significant morbidity and mortality (M&M) in low- and middle-income countries. Implementation of quality improvement (QI) programs has been shown to be a cost-effective strategy to improve trauma care quality. In this study, we aim to characterize the trauma QI programs in a broad range of low- to high-income countries in the Americas to assess areas for targeted improvement in global trauma QI efforts. METHODS: We conducted a mixed methods survey of trauma care providers in North and South America distributed in-person at trauma care conferences and online via a secure survey platform...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29142758/ethnic-differences-in-patients-perceptions-towards-isolated-orthopedic-injuries-a-pilot-study
#4
Boris A Zelle, Gurpreet Singh, Deanna L Kitchen, Roberto J Fajardo, Mohit Bhandari, Melissa A Valerio
Background: Patients' perceptions of their healthcare have been reported to influence clinical outcomes following orthopedic trauma. Findings across clinical outcomes have demonstrated significant differences in perceptions towards healthcare between Hispanics and non-Hispanic whites. However, ethnic disparities in perceptions towards orthopedic injuries have not been examined in the literature. Aim of study: The aim of this pilot study is to explore whether Hispanic patients with isolated orthopedic injuries will demonstrate different perceptions towards their injury as compared to non-Hispanic white patients...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29103789/an-in-situ-simulation-based-educational-outreach-project-for-pediatric-trauma-care-in-a-rural-trauma-system
#5
Lilly Bayouth, Sarah Ashley, Jackie Brady, Bryan Lake, Morgan Keeter, David Schiller, Walter C Robey, Stephen Charles, Kari M Beasley, Eric A Toschlog, Shannon W Longshore
BACKGROUND: Outcome disparities between urban and rural pediatric trauma patients persist, despite regionalization of trauma systems. Rural patients are initially transported to the nearest emergency department (ED), where pediatric care is infrequent. We aim to identify educational intervention targets and increase provider experience via pediatric trauma simulation. METHODS: Prospective study of simulation-based pediatric trauma resuscitation was performed at three community EDs...
October 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29101529/an-overview-of-cytokines-and-heat-shock-response-in-polytraumatized-patients
#6
REVIEW
Maria Concepción Guisasola, Berta Alonso, Beatriz Bravo, Javier Vaquero, Francisco Chana
Early after injury, local tissue damage induces a local and systemic inflammatory response that activates the immune system and leads to the development of systemic inflammatory response syndrome (SIRS). This post-traumatic response often results in uncontrolled release of inflammatory mediators and over-activation of the immune system, which occasionally results in multiple organ dysfunction syndrome (MODS). In parallel, a state of immunosuppression develops. This counter-regulating suppression of different cellular and humoral immune functions has been termed "compensatory anti-inflammatory response syndrome (CARS)...
November 3, 2017: Cell Stress & Chaperones
https://www.readbyqxmd.com/read/29033079/polytrauma-patients-in-the-netherlands-and-the-usa-a-bi-institutional-comparison-of-processes-and-outcomes-of-care
#7
Suzan Dijkink, Gwendolyn M van der Wilden, Pieta Krijnen, Lisa Dol, Steven Rhemrev, David R King, Marc A DeMoya, George C Velmahos, Inger B Schipper
BACKGROUND: Modern trauma systems differ worldwide, possibly leading to disparities in outcomes. We aim to compare characteristics and outcomes of blunt polytrauma patients admitted to two Level 1 Trauma Centers in the US (USTC) and the Netherlands (NTC). METHODS: For this retrospective study the records of 1367 adult blunt trauma patients with an Injury Severity Score (ISS) ≥ 16 admitted between July 1, 2011 and December 31, 2013 (640 from NTC, 727 from USTC) were analysed...
October 10, 2017: Injury
https://www.readbyqxmd.com/read/29019632/racial-and-ethnic-health-disparities-and-trauma-informed-care-for-children-exposed-to-community-violence
#8
Bradley C Stolbach, Seeba Anam
Racial and ethnic disparities in health outcomes and access have been consistently documented for a wide variety of physical and behavioral health conditions. Health inequities are most pronounced in areas with high levels of racial and ethnic segregation, where children and adolescents are also more likely to face economic inequality, which places them at high risk for exposure to neighborhood violence and traumatic loss. Community violence exposure (CVE) has been increasingly recognized as a prominent contributor to negative physical and mental health outcomes...
October 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/29017982/clinical-presentation-diagnosis-and-surgical-treatment-of-spontaneous-cervical-intradural-disc-herniations-a-review-of-the-literature
#9
REVIEW
Arunprasad Gunasekaran, Nova Kristine M de Los Reyes, Jerry Walters, Noojan Kazemi
OBJECTIVE: Spontaneous cervical intradural disc herniation (IDH) is a rare occurrence with limited and disparate information available regarding its presentation, diagnosis, and treatment. However, its accurate detection is vital for planning surgical treatment. In this review of the literature, we collected data from all cervical intradural disc herniations described to date. Particular attention is paid to diagnostic findings, surgical approach and causation for cervical IDH, especially at the cervicothoracic junction...
October 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28974313/disparate-effects-of-catecholamines-under-stress-conditions-on-endothelial-glycocalyx-injury-an-in%C3%A2-vitro-model
#10
Jonathan V Martin, David M Liberati, Lawrence N Diebel
BACKGROUND: Geriatric trauma patients have high circulating norepinephrine (NE) levels but attenuated release of epinephrine (Epi) in response to increasing severity of injury. We hypothesized that NE and Epi have different effects on the endothelial and glycocalyx components of the vascular barrier following shock. METHODS: Human umbilical vein endothelial cells (HUVEC) were treated with varying concentrations of NE or Epi and exposed to simulated shock conditions (HR)...
September 22, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28965684/universal-health-insurance-and-its-association-with-long-term-outcomes-in-pediatric-trauma-patients
#11
Meesha Sharma, Andrew J Schoenfeld, Wei Jiang, Muhammad A Chaudhary, Anju Ranjit, Cheryl K Zogg, Peter Learn, Tracey Koehlmoos, Adil H Haider
BACKGROUND: Racial disparities in mortality exist among pediatric trauma patients; however, little is known about disparities in outcomes following discharge. METHODS: We conducted a longitudinal cohort study of children admitted for moderate to severe trauma, covered by TRICARE from 2006 to 2014. Patients were followed up to 90days after discharge. All children <18 years with a primary trauma diagnosis, an Injury Severity Score >9 and 90days of follow-up after discharge were included...
September 23, 2017: Injury
https://www.readbyqxmd.com/read/28961649/the-louisiana-mental-and-behavioral-health-capacity-project-trauma-informed-integrated-care-model-and-improved-posttraumatic-stress-outcomes
#12
Howard J Osofsky, Joy D Osofsky, Tonya Cross Hansel, Trevor Flynn
OBJECTIVE: The Mental and Behavioral Health Capacity Project in Louisiana has been addressing health disparities by increasing accessibility and availability through integrating services into primary care clinics. Integrated health is becoming the standard of care, providing an opportunity to address the trauma-specific needs of communities, and allowing for informed and less stigmatized services. The purpose of this study is to test the efficacy of the Mental and Behavioral Health Capacity Project in Louisiana model in the primary care settings to reduce posttraumatic stress symptoms and physical health complaints...
November 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28868929/voices-and-views-of-congolese-refugee-women-a-qualitative-exploration-to-inform-health-promotion-and-reduce-inequities
#13
Shannon McMorrow, Jyotika Saksena
Refugees have recently been thrust into the spotlight worldwide. The strikingly negative rhetoric currently surrounding refugees calls for increased action from public health educators. In 2016, the largest proportion of refugees to the United States came from the Democratic Republic of Congo. This presents the opportunity to explore health needs as Congolese refugees resettle in the United States, with women taking priority due to health disparities linked to gender-based discrimination, trauma, sexual and gender-based violence, lower literacy rates, and less access to learning English...
September 1, 2017: Health Education & Behavior: the Official Publication of the Society for Public Health Education
https://www.readbyqxmd.com/read/28844826/pregnant-trauma-victims-experience-nearly-2-fold-higher-mortality-compared-to-their-nonpregnant-counterparts
#14
Neha A Deshpande, Lauren M Kucirka, Randi N Smith, Corrina M Oxford
BACKGROUND: Trauma is the leading nonobstetric cause of death in women of reproductive age, and pregnant women in particular may be at increased risk of violent trauma. Management of trauma in pregnancy is complicated by altered maternal physiology, provider expertise, potential disparate imaging, and distorted anatomy. Little is known about the impact of trauma on maternal mortality. OBJECTIVE: We sought to: (1) characterize nonviolent and violent trauma among pregnant women; (2) determine whether pregnancy is associated with increased mortality following traumatic injury; and (3) identify risk factors for trauma-related death in pregnant women...
August 24, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28789695/clinical-profile-and-comorbidity-of-traumatic-brain-injury-among-younger-and-older-men-and-women-a-brief-research-notes
#15
Vincy Chan, Tatyana Mollayeva, Kenneth J Ottenbacher, Angela Colantonio
OBJECTIVE: Comorbid disorders influence the course and outcomes of rehabilitation following traumatic brain injury (TBI), yet sex- and age-related disparities in the frequency distribution of these disorders remain poorly understood. We aimed to describe comorbid disorders by the International Classification of Diseases in patients with TBI undergoing inpatient rehabilitation in Ontario, Canada over a 3-year period, by sex and age, and discuss their potential impact on rehabilitation outcomes...
August 8, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28774762/epidemiology-of-mild-traumatic-brain-injury-with-intracranial-hemorrhage-focusing-predictive-models-for-neurosurgical-intervention
#16
Alessandro Orlando, A Stewart Levy, Matthew M Carrick, Allen Tanner, Charles W Mains, David Bar-Or
OBJECTIVE: To outline differences in neurosurgical intervention (NI) rates between intracranial hemorrhage (ICH) types in mild traumatic brain injuries and help identify which ICH types are most likely to benefit from creation of predictive models for NI. METHODS: A multicenter retrospective study of adult patients spanning 3 years at 4 U.S. trauma centers was performed. Patients were included if they presented with mild traumatic brain injury (Glasgow Coma Scale score 13-15) with head CT scan positive for ICH...
November 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28766317/chronic-childhood-trauma-mental-health-academic-achievement-and-school-based-health-center-mental-health-services
#17
Satu Larson, Susan Chapman, Joanne Spetz, Claire D Brindis
BACKGROUND: Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers (SBHCs) may be one strategy to decrease health disparities. METHODS: Empirical studies between 2003 and 2013 of US pediatric populations and of US SBHCs were included if research was related to childhood trauma's effects, mental health care disparities, SBHC mental health services, or SBHC impact on academic achievement...
September 2017: Journal of School Health
https://www.readbyqxmd.com/read/28765795/inpatient-versus-outpatient-anterior-cervical-discectomy-and-fusion-a-perioperative-complication-analysis-of-259-414-patients-from-the-healthcare-cost-and-utilization-project-databases
#18
Shearwood McClelland Iii, Peter G Passias, Thomas J Errico, R Shay Bess, Themistocles S Protopsaltis
BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is one of the most common operations utilized to address pathology of the cervical spine. Few reports have attempted to compare complications associated with inpatient versus outpatient ACDF. METHODS: The Nationwide Inpatient Sample (NIS) from 2001-2012 and the State Ambulatory Services Database (SASD) for New Jersey (NJ) from 2003-2012 were used for analysis. Patients receiving ACDF (defined as anterior cervical fusion (ICD-0 code=81...
2017: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/28732498/a-qualitative-study-on-the-intersectional-social-determinants-for-indigenous-people-who-become-infected-with-hiv-in-their-youth
#19
Roberta L Woodgate, Melanie Zurba, Pauline Tennent, Carla Cochrane, Mike Payne, Javier Mignone
BACKGROUND: Indigenous young people are currently highly overrepresented in the HIV epidemic in Canada, especially in the Prairie Provinces, such as Manitoba. Understanding HIV-vulnerability in Indigenous peoples must begin with understanding that social determinants are intersectional and linked to the historical legacy of European colonization. In this paper findings that detail the influence of the intersectional social determinants on Indigenous people who become infected with HIV in their youth are presented...
July 21, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28731843/telemedicine-use-decreases-rural-emergency-department-length-of-stay-for-transferred-north-dakota-trauma-patients
#20
Nicholas M Mohr, J Priyanka Vakkalanka, Karisa K Harland, Amanda Bell, Brian Skow, Dan M Shane, Marcia M Ward
BACKGROUND: Telemedicine has been proposed as one strategy to improve local trauma care and decrease disparities between rural and urban trauma outcomes. OBJECTIVES: This study was conducted to describe the effect of telemedicine on management and clinical outcomes for trauma patients in North Dakota. METHODS: Cohort study of adult (age ≥18 years) trauma patients treated in North Dakota Critical Access Hospital (CAH) Emergency Departments (EDs) from 2008 to 2014...
July 21, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
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